The World Health Organisation estimates that over ⅓ of the world's population are latently infected with Mycobacteria. More than 60 million people are tested for Mycobacterial infections each year. Initial investigations and follow up of latent and multidrug resistant infections costs £1.5 billion worldwide, with treatment of UK cases of multidrug resistant Mycobacterial infections costing up to £7,000 per patient.
Culture of a pathogen from an appropriate patient sample is still the gold standard for diagnosis. Despite over 100 years of development in Mycobacteria culture methodology, producing growth is frustratingly slow (up to six weeks), inaccurate and particularly in samples with low numbers of pathogens, can be impossible. This is because, as adapted intracellular human pathogens, Mycobacteria are able to stop dividing and become dormant on entry into the host. Initiating Mycobacterial re-growth from patient samples to obtain a diagnosis is not assured. Those proportions of bacteria that do begin growing often require many weeks, sometimes months, to generate observable growth. This slow detection time is detrimental to effective national health strategies dealing with Mycobacterial disease; it has led to culture methods being of only retrospective worth. Until now, simple reproducible methods or stable preparations able to achieve reliable growth stimulation have not been identified.